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Part 1 > Ocular Anatomy > Flashcards

Ocular Anatomy Flashcards

1
Q

What are the 7 layers of the eyelid?

A
  1. Skin
  2. Subcutaneous Areolar
  3. Orbicularis
  4. Submuscular Areolar
  5. Orbital Seption
  6. Posterior Muscular
  7. Tarsal Plate
  8. Palpebral Conjunctiva
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2
Q

What is telecanthus?

A

Abnormally increased distance b/n the medial canthi of the lids

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3
Q

Trichiasis is secondary to what?

A

Entropion

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4
Q

What is Phthiriasis palpebrarum is caused by?

A

infections of lashes caused by phthirus pubis

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5
Q

The skin layer contains what 3 things?

A
  1. Fine hairs
  2. Sweat glands
  3. Sebaceous glands
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6
Q

Where is the thinnest skin layer of the body?

A

Eyelid

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7
Q

T/F the skin layer of the eyelid contains fat?

A

False

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8
Q

What kind of CT is found in the subcutaneous and submuscular areolar layer?

A

Loose CT

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9
Q

What structure can be found in the subcutaneous layer of the eyelid?

A

Levator aponeurosis

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10
Q

What structure does the orbicularis layer of the eyelid contain?

A

Palpebral portion of the orbicularis oculi

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11
Q

What nerve innervates the Orbicularis Oculi?

A

CN7

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12
Q

What is the orbital portion of the Orbicularis Oculi in charge of?

A

Forced blinks

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13
Q

What is the palpebral portion of the Orbicularis Oculi in charge of?

A

Spontaneous and reflex blinking

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14
Q

What are the two portions of the palpebral portion of the Orbicularis Oculi?

A
  1. Muscle of Riolan (pars ciliaris)

2. Muscle of Horner (pars lacrimalis)

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15
Q

The muscle of Horner is in charge of?

A

Tears: encircles canaliculi to help drain tears

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16
Q

The muscle of Riolan is in charge of?

A

Roll: rotating lashes

Tide: keeps it tight

Divide: gray line

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17
Q

Paralysis of the orbicularis will eventually result in a condition known as..?

A

Ectropion: lower lid droops away from globe

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18
Q

What structures does the submuscular areolar layer contain?

A

Upper: Levator aponeurosis

Palpebral potion of the main lacrimal gland

Upper and Lower: Peripheral and Marginal arcades

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19
Q

What are four pertinent negatives that you should have for orbital cellitus?

A
  1. Fever
  2. Decreased Vision
  3. EOM restriction
  4. Pain
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20
Q

What kind of CT is the orbital septum?

A

Dense Irregular CT

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21
Q

What are the function(s) of the orbital septum

A
  1. Barrier to the orbit in the upper and lower lids
  2. Prevents fat from falling down onto lid margins
  3. Keeps infection localized to anterior portion of the eyelid, away from the orbit
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22
Q

What meds would you give for Orbital Cellulitis?

NOTE: polymicrobial (staph & strep)

A
  1. Augmentin: cell wall synthesis inhibitor
  2. Cephalexin: cell wall synthesis inhibitor
  3. Azithromycin: 50S subunit
  4. Doxycycline: 30S
  5. Fluroquinolones: DNA synthesis inhibitor
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23
Q

What becomes the orbital septum?

A

Peri-orbita: loosely covers orbital bones

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24
Q

What is the orbital septum continuous with?

A

Periorbita and periosteum of skull

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25
Q

What attaches to the orbital septum medially

A

Posterior Lacrimal Crest

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26
Q

Does the orbital septum protect the lacrimal sac from infection?

A

Yes - Located posterior

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27
Q

What layer is the insertion site of the levator aponeurosis?

A

Superior Orbital Septum

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28
Q

What structures are in the posterior muscular layer?

A
  1. Superior levator Palpebrae

2. Muller’s muscles (superior and inferior)

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29
Q

Superior Levator Palpebrae originates from where?

A

Lesser wing sphenoid

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30
Q

What is the function of the Superior Levator Palpebrae?

A

Main retractor of upper lid

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31
Q

What is Whitnal’s ligament?

A

Fulcrum of the Superior Levator Palpebrae that allows muscle to change course from anterior posterior to superior inferior

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32
Q

What is the Levator aponeurosis?

A

Fanned shaped tendon of Superior Levator Palpebrae that attaches to skin and anterior surface

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33
Q

What does the levator aponeurosis attach to (3 places)

A
  1. Skin
  2. Orbicularis/Subcutan
  3. Tarsal plate
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34
Q

Where is the attachment of the levator aponeurosis to the skin of upper lid form?

A

Superior palpebral furrow

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35
Q

Where does the lateral horn of the levator aponeurosis attach to?

A

Whitnal ligament

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36
Q

Where does the medial horn of the levator aponeurosis attach to?

A

medial palpebral ligament

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37
Q

How is the inferior palpebral furrow formed?

A

Indirect attachment of the inferior rectus muscle into skin

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38
Q

What does the eyelid furrows separate?

A

Tarsal and orbital portions of lid

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39
Q

Muscle of Muller is what kind of muscle?

A

Smooth Muscle

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40
Q

Muscle of Muller has what kind of receptors and is innervated by what?

A

A2

Sympathetic nervous system

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41
Q

Where does the inferior tarsal muscle originate from?

A

Fascial sheath of inferior rectus

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42
Q

Horner’s syndrome is a DEC in which innervation?

A

Sympathetic

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43
Q

What is happening when the lid is retracted back too much

A
  1. Too much sympathetic (overaction of mueller)

2. Thyroid issue

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44
Q

When you hear Thyroid eye disease, what should you think?

A

Fibroblast proliferation

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45
Q

What is a normal Interpalpebral fissure distance?

A

10-12

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46
Q

Tarsal plate is made of what kind of connective tissue

A

Dense irregular

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47
Q

Tarsal plate structure

A

Horizontal and vertical collagen fibrils that surround meibomian glands

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48
Q

What kind of glands are meibomian glands?

49
Q

What layer are meibomian glands located in?

50
Q

How many meibomian glands on top and bottom lids?

A

25 and 20 respectively

51
Q

Upper and lower tarsal plates combine to form

A

Medial and lateral palpebral ligaments

52
Q

The medial palpbral ligament attaches to where?

A

Maxillary Bone

53
Q

Lateral palebral ligament attaches to where?

A

Whitnall’s ligament

54
Q

What kind of gland/secretions are meibomian and Zeiss?

A

Sebaceous and Holocrine

55
Q

Zeiss gland function?

A

Lubricates lashes

56
Q

What kind of gland is Gland of Moll?

57
Q

What layer and macrophages, PNMs to protect from infection

A

Palpebral conjunctiva

58
Q

What are the layers of the palpebral conjunctiva?

A
  1. Epithelial layer

2. Stroma

59
Q

Is the epithelial layer of the palpebral conj stratified?

60
Q

Goblet cells found in where?

A

Palpebral conj mostly inferior nasal fornix

61
Q

Stroma layer of the palpebral conj is what kind of CT?

A

Loose vascularized CT

62
Q

Two layers of the stroma layer of palpebral conj?

A
  1. Superficial lymphoid layer

2. Deep fibrous layer

63
Q

Stroma of Palpebral Conj aka

A
  1. Submucosa

2. Substantia propria

64
Q

The Superficial lymphoid layer of Stroma of Palebral Conj contains

A

IgA Macrophages, mast cells, PMNs and eosinophils (immunologically active)

65
Q

The deep fibrous layer of Stroma of Palebral Conj function

A

Connects the conj to underlying internal structures continuous with tarsal plate

66
Q

What does the deep fibrous layer of Stroma of Palebral Conj contain?

A
  1. Accessory lacrimal glands

2. Wolfring and Krause

67
Q

Internal hordeolums are infections of what gland?

68
Q

External hordeolums are infections of what gland?

69
Q

What kind of gland is the gland of Moll?

A

Aprocrine and Sweat

70
Q

Krause and Wolfring gland is what kind of gland

A

Accessory lacrimal and merocrine

71
Q

Wolfring gland is found where?

A

Tarsal conj

Deep fibrous layer of stroma of palpe conj

72
Q

What are the Holocrine glands of the eye?

A

Meibomian and Zeiss

73
Q

What are the Apocrine glands of the eye?

A

Moll and Goblet

74
Q

What are the Merocrine glands of the eye?

A

Lacrimal, krause, wolfring

75
Q

What branch of 7 innervates the orbicularis oculi for voluntary motor

A

Zygomatic branch of the facial nerve

76
Q

What branches innervate the upper eyelids for sensory?

A
  1. Supraorbital and supratrochlear branches of the frontal branch of V1
  2. Lacrimal branch of V1
77
Q

What are the direct branches of V1

A
  1. Nasociliary
  2. Frontal
  3. Lacrimal
78
Q

What branches innervate the lower eyelids for sensory?

A
  1. Medial: infratrochlear branch of nasociliary branch of V1
  2. Zygomaticalfacial of Zygomatic of V2
  3. Infraorbtial of V2
79
Q

What supplies blood to the deep eyelid structures?

A

Palpebral arcades

80
Q

Palpebral arcades are formed by the union of the?

A

medial palpebral artery and the lateral palpebral artery

81
Q

Medial palpebral artery is a branch of the?

A

ophthalmic artery

82
Q

The lateral palpebral artery is a branch of the?

A

lacrimal artery

83
Q

What provides blood the the bulbar conj and ciliary body?

A

Anterior ciliary arteries

why pt’s with uveitis get circumlimbal injections and decrease aq humor production

84
Q

What provides blood to the superficial areas of the lid?

A

Facial artery of the external carotid

85
Q

Veins of the lid run _____ to arteries

86
Q

Where do the veins of the lids drain into?

A

palpebral and ophthalmic veins

87
Q

Lateral lymphatics of the conj drain into

A

Parotid lymph nodes

88
Q

Medial lymphatics of the conj drain into

A

Submandibular lymph nodes

89
Q

What are the infections that cause Preauricular lymphadenopathy

A

Viral Conj (Herpes, EKC)

Chlamydia

Dacryoadenitis

Gonorhea (only bacteria that does)

Parinaud’s oculoglandular Syndrome

90
Q

Parinauds oculoglandular sydrome presents with what?

A

Significant Preauricular and Submandibular Lymphadenopathy

91
Q

What causes follicles on conj?

A

CHAT

  1. Chlamydia
  2. Herpes
  3. Adenovirus
  4. Toxic (Brominidine)
92
Q

The corrugator muscle function:

A

Medial depressor, runs obliquely

Pulls the corner of the eyebrows down and in

Occurs during concentration

93
Q

The Procerus muscle function:

A

Medial depressor on bridge of nose

Pulls the skin b/n eyebrows straight down

Flares nose- Anything to do with nose

94
Q

What divides the lacrimal gland into two portions?

A

Levator Aponeurosis

95
Q

Lacrimal gland is what kind of gland

A

Exocrine gland with merocrine secretion

96
Q

What branches of what artery supplies the lacrimal gland

A

Glandular branches of the lacrimal artery

97
Q

What drains the lacrimal gland

A

Lacrimal vein

98
Q

What part of the orbit contains the only lymphatic vessels

A

Lacrimal gland

99
Q

Where does the lacrimal gland receive its innervation? What kind of innervation is ti?

A

Parasympathetic: Lacrimal nerve of the pterygopalatine (sphenopalitine) ganglion of CN VII

100
Q

Reasons for Epiphora?

A
  1. Ectropion
  2. Overproduction of tears
  3. Underdrainage
101
Q

Overproduction of tears can be caused by what?

A
  1. Allergy
  2. Dry eye syndrome
  3. Corneal irritation
102
Q

Underdrainage of tears is cause by what?

103
Q

Nasal Lacrimal Duct Obstruction in old people is caused by what?

A

1 reason is AGE (related to stenosis or involutional stenosis)

Another reason: Maxillary Sinus Infection

104
Q

Nasal Lacrimal Duct Obstruction in Young people is caused by what?

A

Valve of Hasner’ issues

105
Q

What is the number one reason for canaliculitis (bacteria)?

A

Actinomyces israelii

106
Q

Causes of Acute Dacryoadenitis (pathogen)?

A
  1. Staph (#1 cause)
  2. Sarcoidosis
  3. Mononucleosis (EBV)
107
Q

What is responsible for keeping the puncta open?

A

Lacrimal Papilla (CT)

NOTE: NOTE: The lacrimal papilla is the small rise in the bottom eyelid just before it ends at the corner of the eye closest to the nose. In the middle of it is the lacrimal punctum, a small hole that lets tears drain into the inside of the nose through the lacrimal canaliculi.

108
Q

How long are canalicular

A

(2+8=10 mm)

109
Q

Structure of Drainage System?

A

Vertical 2 mm

Horizontal 8 mm

Common Canaliculi

Lacrimal system

NLD

Hasner

110
Q

What prevents backflow from lac sac?

A

Angle of Common Canaliculi

111
Q

What muscle surrounds the Canalilculi to assist in tear drainage?

A

Muscle of Horner

112
Q

Where does the Lacrimal Sac lie within?

A

Fossa of medial orbit wall, formed by post lacrimal crest of lacrimal bone and ant lacrimal crest of maxillary bone

113
Q

How long is lac sac?

114
Q

What cells are in the lacrimal sac?

A
  1. Double epithelium (superficial columnar and deep basal)
  2. Goblet cells
  3. Microvilli
115
Q

What ligament straddles the lacrimal sac?

A

Medial palpebral ligament

116
Q

What divides the lacrimal sac into upper and lower section?

A

Muscle of Horner

117
Q

What is Dacryocystitis cause by?

A
  1. Infection of lacrimal sac caused by NLDO
118
Q

What makes of the Medial wall of the Orbit?

A

SMEL

Sphenoid (body)
Maxilla
Ethmoid
Lacrimal

(thinnest and smallest wall of orbit)

Part 1 (31 decks)

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